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Cyclospora under a microscope. Courtesy CDC

The Virginia Department of Health has identified three workplace cafeterias in Northern Virginia and the Richmond area in connection with an outbreak of intestinal illness associated with the parasite cyclospora.

An increase in cases was first identified in Northern Virginia in mid-June 2019. The health department investigation has found an additional outbreak in Central Virginia. A food or water source of these outbreaks has not yet been identified, the agency said in a Thursday news release.

Since May 1, there have been 39 confirmed cases of cyclosporiasis in Virginia, 27 of those in Northern Virginia.

The five-year average for the same time frame from 2014 to 2018 was nine cases.

Workplace cafeterias in the following locations are part of the ongoing investigation, the health department said:

  1. Capital One Building at 1600 Capital One Drive, McLean, VA 22102
  2. Valo Park Building at 7950 Jones Branch Drive, McLean, VA 22102
  3. CarMax at 12800 Tuckahoe Creek Parkway, Richmond, VA 23238

These cafeterias are not widely accessible to the general public. Health officials are working directly with business owners and affected individuals.

"Public health investigations are complex and it takes time to gather information about exposures, risk factors and illnesses," the VDH news release said. "In some cases outbreak investigations may not identify a likely source."

Anyone experiencing symptoms of cyclosporiasis should visit their healthcare provider. They can test for cyclospora and prescribe the correct treatment.  Physicians will report cases to the health department.

What is cyclosporiasis?

Cyclosporiasis is an intestinal illness caused by a microscopic parasite. People can become infected by consuming food or water contaminated with feces or stool that contains the parasite. Illness occurs most often in tropical and subtropical regions. In the United States, past foodborne outbreaks of Cyclosporiasis have been linked to various types of imported fresh produce, such as raspberries, basil, arugula, snow peas, mesclun lettuce, and cilantro. Of 39 U.S. Cyclospora outbreaks between 2000 and 2017, none have been associated with commercially frozen or canned products.

Symptoms:

Cyclosporiasis typically causes watery diarrhea, with frequent, sometimes explosive, stools within one to two weeks after exposure. Other common symptoms include loss of appetite, weight loss, abdominal cramping or bloating, nausea and prolonged fatigue. Vomiting, body aches, low-grade fever, and other flu-like symptoms may be noted. If untreated, the illness may last for a few days to a month or longer and may seem to go away but come back again.

Prevention:

Safely handling fruit and vegetables is the best way to prevent Cyclosporiasis:

  • Wash: Wash hands with soap and warm water before and after handling or preparing fruits and vegetables.
  • Prepare: Wash all fruits and vegetables thoroughly under running water before eating, cutting, or cooking.
  • Fruits and vegetables that are labeled “prewashed” do not need to be washed again at home. Scrub firm fruits and vegetables, such as melons and cucumbers, with a clean produce brush. Cut away any damaged or bruised areas on fruits and vegetables before preparing and eating.
  • Store: Refrigerate cut, peeled, or cooked fruits and vegetables as soon as possible, or within 2 hours.

For more information, visit www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/cyclosporiasis/ or www.cdc.gov/parasites/. For questions, please contact your local health department office. Locate contact information for your closest office at www.vdh.virginia.gov/health-department-locator.

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